Section of Pulmonary and Critical Care Medicine

The Section of Pulmonary and Critical Care Medicine was established in November 1999 and has six full-time and two part-time faculty members. A three-year pulmonary medicine fellowship-training programme has been approved by the department of Postgraduate Medical Education (PGME) at Aga Khan University and inspected by the College of Physicians and Surgeons Pakistan (CPSP).  The faculty participates in General Medicine emergency admissions, and rotating residents are provided with supervised training in all aspects of Pulmonary Medicine. The service regularly admits patients with asthma, chronic obstructive pulmonary disease, restrictive lung disease, pulmonary embolism, pulmonary tuberculosis and other infections, pleural effusion and other diseases of the chest.  Research interests of the section include pulmonary tuberculosis, tobacco control and prevention, sleep apnea, and management of critically ill patients.

Clinical services of this academic section include intensive care management,
non-invasive ventilation (an advancement in the care of patients with respiratory failure), fibreoptic bronchoscopy, a sleep-disorder laboratory and an allergy clinic.  The section provides state-of-the-art facilities for the management of pulmonary diseases.  The facilities and capabilities include:

• A pulmonary function laboratory which performs spirometry, and which will shortly have facilities for measuring transfer factors and lung volumes as well;
• An endoscopy suite for performing fibreoptic bronchoscopy, endobronchial biopsy and transbronchial biopsy under fluoroscopic control;
• A sleep laboratory for the diagnosis and therapy of sleep-related breathing disorders;
• A high resolution/spiral computed tomography (CT) for evaluation of patients with interstitial lung disease, lung tumor, and other pulmonary pathology.  Diagnostic CT-guided needle biopsy is performed regularly; 

Clinical laboratory is well equipped to perform bacterial, mycobacterial, and fungal cultures, polymerase chain reaction (PCR) testing for tuberculosis, and various serologic tests useful in the investigation of pulmonary diseases encountered in Pakistan and the region.

The ever-growing academic environment of the section includes weekly pulmonary radiology meeting attended by large numbers of students, residents, and pulmonary, radiology and cardio-thoracic faculty. The students grade this as one of the best teaching activities in the Department. In addition, there is a weekly journal club presented by the faculty. The faculty participates actively in Continuous Medical Education (CME) and public awareness seminars held at AKU and in other institutions.

The Section is actively involved in a number of research projects. The ongoing research topics include outcome of patients with respiratory failure, use of non-invasive ventilation in Type II respiratory failure, outcome of tuberculosis in patients with chronic liver disease, outcome of tuberculosis treated with a different maintenance regimens and prevention of infections in ICU. A number of other research projects are under way on asthma, sleep apnea, smoking and tuberculosis. A weekly research meeting is held to review the ongoing research projects in the Section.

Section of Pulmonary and Critical Care Medicine , Aga Khan University Hospital, Karachi